REVIEW PAPER

Creativity and Mental Illness: Is There a Link?

1
Charlotte Waddell, MSc, MD, CCFP, FRCpc

Objective: To critically assess the scientific evidence for associating creativity with mental illness.
Method: MEDLINE and secondary literature searches identified 29 studies and 34 review articles on creativity
and mental illness. All studies were critically evaluated. Reviews were also assessed.
Results: Of 29 studies that evaluated possible associations between creativity and mental illness, 15 found no
evidence to link creativity and mental illness, 9 found positive evidence, and 5 had unclear findings. Most studies
used flawed methodologies with weak (case series or case control) designs. There were no randomized or
prospective cohort studies. Adequate criteria for determining causal association were not met. In 34 selective
reviews, despite mixed evidence, many authors asserted that creativity and mental illness were positively or
causally associated.
Conclusions: There is limited scientific evidence to associate creativity with mental illness. Despite this, many
authors promoted a connection. Explanations for this contradiction are explored, and social and research
implications are discussed.

(Can J Psychiatry 1998;43:166-172)

Key Words: creativity, mental illness

reativity and mental illness have long been popularly methodological problems as well as social and research im-
C associated. Until recently, few studies have examined
this purported association using scientific methods. A spate
plications are discussed.

ofrecent review articles, as well as memoirs ofmental illness What Is Creativity?

by prominent, creative individuals, have coincided with sci-
entific interest in possible associations between creativity and
mental illness. These studies, reviews, and memoirs have
garnered media attention and reinforced popular views that
creativity and mental illness are positively associated.
Despite the interest in linking creativity and mental illness,
there have been no recent comprehensive, critical reviews of
the literature. This review examines the studies on creativity
and mental illness and critically assesses the scientific evi-
dence for an association. Reviews are also assessed, and
Manuscript received March 1997, revised and accepted May 1997.
IDepartment of Psychiatry, McMaster University, Hamilton, Ontario.
Address for correspondence: Dr C Waddell, Department of Psychiatry,
McMaster University, 1200 Main Street West, Hamilton, ON L8N 325
In the diverse literature on creativity, many authors have
suggested definitions of creativity. Becker equated creativity
with genius or intellectual giftedness (1). Richards suggested
that intelligence was necessary but not sufficient for creativity
(2). Storr defined creativity as a dynamic of normal drives to
play (3). Independence was mentioned by Andreasen and
Glick (4), and fluency and flexibility were cited by Jamison
as essential to creativity (5).
Rothenberg defined creativity as the ability to simultane-
ously conceive opposites or antitheses (6). Ludwig com-
mented that creativity required both unconventionality and a
drive to communicate (7-9). Both Richards and Ludwig
noted that evaluations of novel or creative products were
always embedded in social and political contexts (2,7-9).
Weisberg stressed that creativity required hard work and
collaboration (10).

In the recent scientific literature, most authors have de-

Can} Psychiatry, Vol 43, March 1998 fined creativity as either processes or products that are both
166
March 1998 Creativity and Mental U1ness
original and worthwhile, as denoted by public recognition or
awards. Creativity in the arts, science, and public leadership
have all been studied, but no universal or psychometrically
standardized definitions of creativity have been accepted.
What is Mental Illness?
There is copious literature on the nature of mental illness,
and many authors have critiqued psychiatric concepts and
definitions. Foucault, a French philosopher and sociologist,
suggested that "madness" was socially constructed to scape-
goat and control people whom society found deviant (11).
Foucault's thought was echoed in many later feminist, socio-
logical, and philosophical critiques of psychiatry, including
critiques that suggested "madness" did not exist apart from
social constructs (12-15).
Most recent authors studying creativity and mental illness
have not debated philosophical definitions. Rather, they have
used standardized definitions of mental illness derived from
the American Psychiatric Association's Diagnostic and Sta-
tistical Manuals of Mental Disorders (DSM) (16-18). A
variety of mental illnesses have been studied in connection
with creativity, with most emphasis placed on mood disor-
ders.
Popular Links Between Creativity and Mental Illness
There is a long history ofassociating creativity and mental
illness in western European cultures, starting with Aristotle,
who equated insanity with genius, and culminating in the
"mad genius" controversy ofthe last 2 centuries (1,2,4-9,19).
Many authors have described famous, creative individuals
who reportedly had mental illnesses (5,6,9,19). Recent ac-
counts in popular media have touted a link between creativity
and various forms of mental illness (20-22).
The popularity ofasserting connections between creativity
and mental illness has also been fueled by recent memoirs of
mental illness by prominent gifted individuals. Campbell, a
Canadian medical scientist, grappled with manic-depression
(23). Styron, an American writer, battled alcohol and depres-
sion (24). Millett, an American feminist, struggled with
manic-depression (and with psychiatrists) (25). Mays, a Ca-
nadian art critic, suffered debilitating bouts of depression
(26). Manic-depression coloured the life of Jamison, an
American psychiatric researcher (27).
In summary, much recent psychiatric and popular litera-
ture has enthusiastically promoted an association between
creativity and mental illness. This enthusiasm, however, has
not always been balanced with scientific evidence.
Method
The literature was searched with MEDLINE using the
following terms: creativity, mental illness, depression,
manic-depression, schizophrenia, and alcohol. The search
was restricted to human, English-language studies from this
century that assessed creativity and mental illness in the same
167
individuals. Citations in primary sources were also searched.
Studies were critically evaluated applying currently accepted
scientific standards. Reviews were also assessed.
Results
The search yielded 29 empirical studies on creativity and
mental illness. Fourteen early studies surveyed creative or
gifted people but did not use standardized definitions of
mental illness. Fifteen later studies used standardized defini-
tions of mental illness: 10 assessed mental illness in creative
or gifted people, 1 assessed creativity in gifted people and
psychiatric patients, and 4 assessed creativity in people with
mental illness. There were also 34 reviews (including letters,
books, and case studies) on creativity and mental illness.
These studies and reviews are summarized.
Early Studies
Fourteen early studies assessed mental illness in creative
or gifted people but did not use standardized or contemporary
definitions ofmental illness. First, starting in 1925, Terman's
group monitored health and social outcomes in 1000 intellec-
tually gifted children over a 30-year period (28). While not
all the gifted children became eminent, they had lower rates
of mental illness than the general population.
In 1926 Ellis's survey of 1020 eminent British people
found rates ofschizophrenia, bipolar disorder, and depression
similar to the general population (29). Nicolson's 1947 sur-
vey of 32 British authors found that only 6% were "insane"
(30). In 1949 Juda reported that the majority of 294 gifted
German artists and scientists surveyed did not have mental
disorders (31).
Drevdahl and Cattell assessed 153 American writers and
artists using personality tests in 1958 (32). Writers and artists
did not have greater psychopathology and were more intelli-
gent, adventurous, and mature than average Americans. In
1962 Goertzel and Goertzel found evidence ofabove-average
rates of depression and suicide in the biographies of 400
eminent people (33).
Torrance, in 1965, reported that although creative children
had less psychopathology, they suffered more sanctions and
hostility and worked alone more than less creative peers (34).
MacKinnon, also in 1965, found that creativity in architects
was associated with unusual profiles on personality tests,
including courage and independence (35).
Noreik and Odegard surveyed 12 000 highly educated
Norwegians in 1966 and found psychiatric admission rates
comparable to the general population (36). Barron's 1968
study of 66 American writers found that while most were
"troubled" according to psychological tests, most also had
greater "ego strength" than average Americans (37).
McNeil's 1971 study of 10 "highly creative" Danish adop-
tees found more "constitutional psychopathy" compared with
less creative comparison subjects (38). Martindale's 1972
168 The canadian Journal of Psychiatry
assessment ofthe biographies of42 English and French poets
suggested that 15% were "psychotic" and half had "some"
psychopathology (39).
Lucas and Stringer's 1972 study of 84 architecture stu-
dents in London found only 1 was "severely disturbed" (40).
Finally, in 1979, Schou described the impact of lithium pro-
phylaxis in 24 artists with bipolar mood disorder (41). Artistic
productivity was increased in 12, unchanged in 6, and reduced
in 6.
These 14 early studies were often cited later as demonstrat-
ing high rates ofmental disorders in creative or gifted people.
In 11 of these studies, however, either high rates of mental
disorders were not clearly found (28-32,34-37,40), or crea-
tive people did better when mental illness was treated (41).
Methodologically, these early studies shared several flaws:
none used standardized or reproducible definitions of mental
illness or creativity, none used randomized selection or
blinded assessments, and most did not use comparison groups
or prospective designs.
Mental Illness in Creative People: Case Series
Six recent case series assessed creative or eminent people
using standardized or clearly reproducible measures of men-
tal illness. Jamison described 47 British writers and artists in
1989: 38% had received treatment for mood disorders at some
time in their lives (42). Ludwig, in 1990, surveyed biogra-
phies of 34 American writers, artists, and musicians and
found that alcohol abuse impaired creativity in 75% (43).
Ludwig later examined the biographies of 1005 eminent
people in academic, business, artistic, social, activist, mili-
tary, and athletic fields, looking for evidence ofeither psychi-
atric difficulty or creativity (44). Writers, actors, artists, and
musicians had the most psychiatric difficulty, while public
officials, scientists, and military and business personnel had
the least. Most creativity was found among musicians, scien-
tists, and artists.
In 1994 Schildkraut's group assessed 15 American artists'
biographies: 50% had suffered either depression or cy-
clothymia, 33% had abused alcohol, and 40% had received
psychiatric treatment at some time in their lives (45).
Also in 1994, Post assessed 291 biographies of eminent
males in music, art, writing, science, and political leadership
(46). He found high rates of psychiatric disorders in writers
and artists. In a later, expanded assessment of writers' biog-
raphies, Post found high rates ofboth depression and alcohol-
ism (47).
Four of these studies found higher than expected rates of
mental disorders in creative or eminent people (42,45-47),
1 found that mental disorder hindered creativity (43), and 1
had unclear findings (44). Methodologically, these studies
shared several flaws: none used control or comparison
groups, none identified or assessed subjects randomly or
blindly, all were retrospective, only I used living subjects
Vol 43, No 2
(42), and none used clearly reproducible measures ofcreativ-
ity.
Mental Illness in Creative People: Case-Control Studies
Four recent case-control studies assessed creative people
using standardized or reproducible definitions of mental ill-
ness. First, in 1974, Andreasen and Canter assessed 15 Ameri-
cans attending a writers' workshop, compared with 15
"non-creative" controls, who were matched for socioeco-
nomic status, age, and gender (48). They found evidence of
lifetime (DSM) psychiatric diagnoses on unblinded inter-
views, mostly mood disorders and alcoholism, in signifi-
cantly more writers than controls (73% versus 20%).
Using object sorting tests, Andreasen and Powers then
compared the 15 writers with 32 patients who were hospital-
ized with either mania or schizophrenia (49). Writers were
more like manic patients than schizophrenic patients, al-
though differences were not significant.
In 1984 Andreasen expanded her sample to 30 writers who
were compared, using unblinded interviews, with 30 "non-
creative" controls matched for age, gender, socioeconomic
status, and intelligence (50). Writers had significantly higher
(DSM) lifetime prevalence rates than controls for all mood
disorders (80% versus 30%), for bipolar disorder (43% versus
10%), and for alcoholism (30% versus 7%).
Finally, Ludwig assessed 59 writers and 59 matched con-
trols using a "lifetime scale" to measure creativity in "every-
day" accomplishments (51). Writers had a 56% lifetime
prevalence ofdepression (versus 14% in controls) and higher
creativity scores.
Three of these studies found significantly higher rates of
mental disorders in creative subjects compared with controls
(48,50,51), and 1 study had unclear findings (49). These
studies, however, shared several methodological flaws: sub-
jects and controls were not identified randomly or assessed
blindly, all used retrospective data, and creativity was actu-
ally measured in only 1 of the studies (51). One study ap-
peared to be a preliminary study (48) that was later
incorporated into a larger study (50).
Creativity in Gifted and Mentally III People
One recent case-control study assessed creativity in both
gifted people and psychiatric patients. In 1983 Rothenberg
used timed word-association tests to measure creativity in 12
Nobel laureates compared with 18 patients, who were hospi-
talized with various psychiatric (DSM) diagnoses (52). He
then compared both groups with 113 "high" and "low" crea-
tivity university students, who were sorted according to re-
cords of achievement in the arts and sciences.
Creativity scores were highest in Nobel laureates, fol-
lowed in descending order by "high" and "low" creativity
students, then psychiatric patients. Differences among the
groups were statistically significant, suggesting to the author
that mental illness was not associated with creativity, al-
March 1998 Creativity and Mental Illness
though mental health was not actually assessed in the Nobel
and university groups.
Creativity in People With Mental Illness: Case Series
Two recent case series assessed creative accomplishments
in people with mental illness. In 1983 Karlsson surveyed
171 000 Icelanders' records and found higher than expected
educational and creative achievement among people who had
been hospitalized for psychosis but not among people who
had been hospitalized for alcoholism (53). In 1988 Akiskal
and Akiskal reported on 750 psychiatric patients: artistic
creativity was more frequent with mild, bipolar mood disor-
ders but less frequent with severe disorders (54). Both studies
were retrospective, and neither used comparison groups or
randomized or blinded assessments.
Creativity in People With Mental Illness: Case-Control
Studies
Two recent case-control studies assessed creativity in peo-
ple with mental disorders using standardized definitions of
mental illness. In 1988 Richards' group hypothesized that
mild mood disorders like cyclothymia might confer greater
creativity than either good health or severe disorders such as
manic-depression (55). They compared 33 manic-depressive
and cyclothymic patients with 11 healthy relatives of the
patients and 33 controls who were either well or had an
unrelated psychiatric diagnosis. They used a "lifetime scale"
to measure peak originality in various endeavours. Mild
mood disorders were associated with higher creativity,
whereas severe illness was associated with lowest creativity,
although differences between groups were not statistically
significant.
In 1993 Funk's group hypothesized that impulsivity might
confer greater creativity (56). They assessed 19 boys with
attention deficit with hyperactivity disorder compared with
21 well controls matched for age, socioeconomic status, and
intelligence. Creativity, assessed using drawing completion
tests, was not significantly higher in subjects (on or off
medication).
Neither study supported a strong association between
mental disorder and creativity. Both studies used cross-sec-
tional designs with matched controls, blinded raters, and clear
measures of both creativity and mental illness.
Reviews
In addition to empirical studies, 34 review and discussion
papers (including books, letters, and case studies) examined
purported links between creativity and mental illness
(1,2,4-9,19-22,57-78). Most were selective reviews that
mixed scientific evidence with journalistic or literary evi-
dence. Only 11 reviews incorporated methodological criti-
cisms (1,2,4-6,9,19,59,62,64,69). Most authors
enthusiastically promoted an association between creativity
and mental illness, and many implied that the association was
causal. There were no metaanalyses.
169
Discussion
In summary, of 29 studies, 15 negated (28-32,
34-37,40,41,43,52,55,56), and 9 supported (33,38,39,42,
45-47,50,51) an association between mental illness and crea-
tivity. Five studies suggested that creativity was hindered by
severe mental illness (41,43,52,54,55), 4 studies had unclear
findings (44,49,53,54), and 1study (48) was incorporated into
a later study (50).
Methodological problems with the studies on the pur-
ported association between creativity and mental illness will
be discussed. A contradiction will be described between the
limited scientific evidence and the resounding enthusiasm for
linking creativity and mental illness. Possible explanations
for this contradiction will be ventured, and social and research
implications will be reviewed.
Methodological Problems
All studies used case-series or case-control designs. Four-
teen early studies did not use standardized measures ofeither
mental illness or creativity. While 15 recent studies used
standardized measures ofmental illness, only 4 (51,52,55,56)
actually measured creativity, none selected subjects ran-
domly, only 3 used prospective designs (52,55,56), and only
2 rated subjects blindly (55,56). Six did not use living subjects
(44-47,53,54).
The quality of research evidence in the health sciences,
including psychiatry, is commonly ranked in order from
strongest to weakest: randomized clinical trials, prospective
cohort studies, case-control studies, case series, and expert
opinion (79).
The 29 empirical studies of creativity and mental illness
used weaker (case-control or case series) designs. There were
34 reviews, yet these comprise the weakest form of evidence
(expert opinion), and none met current critical standards for
literature reviews (80). Many authors apparently suggested
that mental illness and creativity were positively associated
based on finding higher than expected rates of mental illness
in selected populations in whom creativity was usually not
(and mental illness was not always) measured.
Since many authors implied that creativity and mental
illness were causally associated (2,4,5,9,19,20,22,45,
47,50,67,68,70), the following epidemiological criteria for
determining causation apply (79). Was there evidence from
experimental studies in humans? Was the association strong
and consistent among studies? Were the temporal relation-
ships correct? Was there a dose-response gradient? Did the
association make epidemiological and biological sense? Was
the association specific and analogous to a previously proven
causal association? In the studies on creativity and mental
illness, these criteria were not met.
There were other methodological problems with the litera-
ture on creativity and mental illness. Early studies did not use
standardized definitions of mental illness, which made com-
170 The Canadian Journal of Psychiatry
pari sons with current population data difficult. Most early
studies also did not measure creativity but simply included
subjects based on eminence or giftedness.
Recent studies did use standardized criteria to assess men-
tal disorders, but they did not always define or measure
creativity clearly, thus making it difficult to compare studies.
Since most studies used unblinded assessments of retrospec-
tive data, selection biases were likely significant. No studies
assessed creativity in community samples for comparison.
Few studies adequately assessed confounding variables, such
as socioeconomic status or intelligence.
Arguably, quantitative scientific standards may be too
reductionistic to apply to studies on creativity and mental
illness. No one, however, applied rigorous qualitative meth-
ods to complement the quantitative ones. Many authors sug-
gested that creativity and mental illness were associated, but
most did not discuss possible neurobiological or social
mechanisms to explain this purported association.
Implications for Future Research
While definitive studies were lacking, some methodologi-
cal improvements would help clarify whether creativity and
mental illness are positively associated.
Larger prospective studies involving randomly selected
living subjects, matched controls, and raters blinded to histo-
ries of illness or creativity would reduce the recall biases
inherent in retrospective or biographical studies. Creativity,
as well as mental illness, should be defined and measured
using standardized instruments such as Richards' scale (55).
Knowledge about creativity and mental illness in repre-
sentative community samples is needed for comparison. Dif-
ferent types ofcreativity (scientific, artistic, business) should
be clarified. While randomized prospective studies would be
difficult to mount, even naturalistic, prospective studies
would be an improvement on the existing work.
Evidence from several different studies, all using random-
ized and prospective methodologies and showing a strong
association between creativity and mental illness, is needed
before a causal relationship can be suggested.
Contradictions in the Literature
Enthusiasm for associating creativity and mental illness
exceeds the scientific evidence and persists despite evidence
to the contrary. What explains this contradiction? One possi-
bility is that the eloquence of creative or gifted people who
comment on their own mental health problems attracts atten-
tion and compels us to spuriously connect their creativity with
their problems.
For instance, James, a philosopher and psychologist, wrote
about depression: "So much for melancholy in the sense of
incapacity for joyous feeling. A much worse form of it is
positive and active anguish, a sort of psychical neuralgia
wholly unknown to healthy life" (81, p 129).
Vol 43, No 2
Lowry, a writer, described alcoholism: "the agonies ofthe
drunkard find their most accurate poetic analogue in the
agonies ofthe mystic who has abused his powers" (82, p 23).
Millett, a feminist, wrote: "During depression the world
disappears. Language itself. One has nothing to say. Nothing"
(25, p 283). Vedder, a rock singer, said: "Ifit hadn't been for
music, I would have shot myself in front of that classroom"
(83, p 93).
Mays, an art critic, said that having depression was like
living in "a clearing bounded by thickets roamed by the
killing black dogs" (26, p xi). Jamison, a psychiatric re-
searcher, described manic-depression: "So why would I want
anything to do with this illness? Because I honestly believe
that as a result of it I have felt more things, more deeply; had
more experiences, more intensely; loved more and been more
loved" (27, p 218).
Clearly, some mental disorders, especially milder ones,
may enhance creativity in some individuals; for instance,
hypomania may be enjoyable and may enhance creativity
more than depression or mania (55,84). This, however, does
not prove a general association between creativity and mental
illness.
In another explanation for the persisting popular links
between creativity and mental illness, Becker commented
that the need to romantically link genius and madness may be
rooted in society's need to regard both as "deviant" (1).
Kessel added, "Ifgeniuses disturb society, ifthey misfit, then
this is another characteristic they share with the mentally ill.
Yet it is a dangerous conjunction to make because the reasons
lying behind the two types of disturbance are so different"
(69, p 203).
Sontag noted that nonrational metaphors can also domi-
nate perceptions of illness: "The romantic view is that illness
exacerbates consciousness. Once that illness was TB; now it
is insanity" (85, p 36). Sontag explained this phenomenon as
a "sublimated spiritualism: a secular, ostensibly scientific
way of affirming the primacy of 'spirit' over matter" (85, p
55-56). Perhaps both mental illness and creativity have be-
come metaphors for nonrational or spiritual needs that are
sublimated in our rational, scientific age.
Kuhn commented that scientists were often slow to accept
their own rational evidence when it contradicted popular
theories (86). He suggested that scientific "revolutions" arose
when evidence accumulated and finally overwhelmed popu-
lar theory, a nonrational phenomenon essential to scientific
change. The contradiction between the enthusiasm and the
lack ofevidence for linking creativity and mental illness may
epitomize Kuhn's thesis.
Conclusions
This review examined the existing scientific evidence for
associating creativity and mental illness. The evidence was
March 1998 Creativity and Mental Ulness
unconvincing based on a critical review of 29 empirical
studies: most did not support an association between creativ-
ity and mental illness, and most had methodological flaws.
Despite this limited evidence, many authors promoted a
positive association in 34 review articles on creativity and
mental illness. The enthusiasm for associating creativity and
mental illness was not supported by the evidence.
Is there any harm in linking creativity and mental illness
despite limited scientific evidence? Eardley commented:
"Society treats artists . . . poorly enough to dissolve the
hardiest among humans ... to put up with all this and still get
by, the artist may actually be in some way more stable,
mentally or emotionally, than the norm" (87, p A15).
We may do more harm than good to the cause ofcreativity
ifwe inadvertently convey the idea that creativity and mental
illness are both forms of deviance. We may do more harm
than good to the cause of alleviating mental illness if we
romanticize mental illness and trivialize its impact by associ-
ating it with creativity. We may do more harm than good if
we fail to note that mental illness impedes creativity or if
promoting an association between creativity and mental ill-
ness takes precedence over either encouraging creativity or
reducing mental illness.
Despite the gap between enthusiasm and solid evidence,
debates about creativity and mental illness have merit. Much
debate appears motivated by a desire to destigmatize mental
illness. The debates may also ultimately encourage more
research on preventing and treating mental illnesses and on
supporting creativity.
Art provides a "path to the sacred and spiritual, even in a
profane and fragmented world" (45, p 486). We need to
encourage creativity and creative people in our midst. We
also need to find more effective ways to prevent, treat, and
destigmatize mental illnesses ofall kinds. We need both good
art and good science. Science and art, creativity and mental
illness may all be trivialized, however, and we may do more
harm than good to those "afflicted" with either creativity or
mental illness ifwe promote romantic associations that over-
look our own best evidence.
Clinical Implication
• There is little evidence to link creativity and mental illness.
Limitation
• This was a single-author review of the literature. Definitive
studies are lacking.
Acknowledgements
The author thanks Russell Joffe, MD, George McLauchlin, MSc,
and Dan Offord, MD for their comments on previous drafts of this
manuscript.
171
References
I. Becker G. The mad genius controversy. London: Sage Publications; 1978.
2. Richards R. Relationships between creativity and psychopathology: an evaluation
and interpretation of the evidence. Genetic Psychology Monographs
1981; I03:261-324.
3. Storr A. The dynamics of creation. New York: Atheneum;J985.
4. Andreasen N, Glick I. Bipolar affective disorder and creativity: implications and
clinical management. Compr Psychiatry 1988;29:207-17.
5. Jamison K. Manic-depressive illness, creativity and leadership. In: Goodwin F,
Jamison K, editors. Manic-depressive illness. New York: Oxford University
Press; 1990. p 332-67.
6. Rothenberg A. Creativity and madness. Baltimore: The Johns Hopkins University
Press; 1990.
7. Ludwig A. Reflections on creativity and madness. Am J Psych other
1989;43:4-14.
8. Ludwig A. Culture and creativity. Am J Psychother 1992;46:454-69.
9. Ludwig A. The price of greatness. New York: The Guilford Press; 1995.
10. Weisberg R. Creativity: beyond the myth of genius. New York: Freeman and
Company; 1993.
11. Foucault M. Madness and civilization. Toronto: Random House; 1965.
12. Chesler P. Women and madness. New York: Avon Books; 1973.
13. Penfold S, Walker G. Women and the psychiatric paradox. Montreal: Eden Press;
1983.
14. Szasz T. The myth of mental illness. Revised edition. New York: Harper and Row;
1974.
15. Sass L. Madness and modernism. Boston: Harvard University Press; 1992.
16. American Psychiatric Association. Diagnostic and statistical manual of mental
disorders (DSM-III). 3rd ed. Washington (DC): American Psychiatric Press; 1980.
17. American Psychiatric Association. Diagnostic and statistical manual of mental
disorders (DSM-III-R). 3rd ed. Revised. Washington (DC): American Psychiatric
Press; 1987.
18. American Psychiatric Association. Diagnostic and statistical manual of mental
disorders (DSM-IV). 4th ed. Washington (DC): American Psychiatric Press; 1994.
19. Jamison K. Touched with fire. Toronto: Maxwell MacMillan Canada; 1993.
20. Jamison K. Manic-depressive illness and creativity. Sci Am 1995;Feb:62-7.
21. Charbonneau L. Some calm for an unquiet mind. The Medical Post 1995 Nov
7:65.
22. Gutin 1. Mental illness: going over the creative edge. The Globe and Mail 1996
Dec 7;Sect 0:6.
23. Campbell M. Not always on the level. Cambridge: Cambridge University Press;
1988.
24. Styron W. Darkness visible: a memoir of madness. New York: Vintage Books;
1990.
25. Millet K. The loony-bin trip. New York: Simon and Schuster; 1990.
26. Mays J. In the jaws of the black dogs: a memoir of depression. Toronto: Viking
Press; 1995.
27. Jamison K. An unquiet mind. New York: Alfred A. Knopf; 1995.
28. Terman L, Cox C, Oden M, Burks B, Jensen D. Genetic studies ofgenius (Volumes
1-5). Stanford: Stanford University Press; 1925-1959.
29. Ellis H. A study of British genius. New York: Houghton Miftlin; 1926.
30. Nicolson H. The health of authors. Lancet 1947;2:709-14.
31. Juda A. The relationship between highest mental capacity and psychic abnormali-
ties. Am J Psychiatry 1949;106:296-307.
32. Drevdahl J, Cattell R. Personality and creativity in artists and writers. J Clin
PsycholI958;14:107-12.
33. Goertzel V, Goertzel M. Cradles of eminence. Boston: Little, Brown; 1962.
34. Torrance E. Rewarding creative behavior: experiments in classroom creativity.
New Jersey: Prentice-Hall; 1965.
35. MacKinnon D. Personality and the realization of creative potential. Am Psychol
1965;20:273-81.
36. Noreik K, Odegard O. Psychoses in Norwegians with a background of higher
education. Br J Psychiatry 1966;112:34-55.
37. Barron F. Creative writers. In: Albert R, editor. Genius and eminence. 2nd ed.
New York: Pergamon Press; 1992. p 315-24.
38. McNeil T. Prebirth and postbirth influence on the relationship between creative
ability and recorded mental illness. J Pers 1971;39:391-406.
39. Martindale C. Father's absence, psychopathology, and poetic eminence. Psychol
Rep 1972;31:843-7.
40. Lucas C, Stringer P. Interaction in university selection, mental health and aca-
demic performance. Br J Psychiatry 1972;120:189-95.
41. Schou M. Artistic productivity and lithium prophylaxis in manic-depressive
illness. BrJ Psychiatry 1979;135:97-103.
42. Jamison K. Mood disorders and patterns ofcreativity in British writers and artists.
Psychiatry 1989;52:125-34.
43. Ludwig A. Alcohol input and creative output. British Journal of Addiction
1990;85:953-63.
172 The canadian Journal of Psychiatry \/.,! .£3, No 2

44. Ludwig A. Creative achievement and psychopathology: comparison among pro- 64. Prentky R. Creativity and psychopathology. New York: Praeger; 1980.
fessions. Am J Psychother 1992;46:330-56. 65. DeLong G, Aldershof A. Association of special abilities with juvenile manic-de-
45. SchildkrautJ, Hirshfeld A, Murphy J. Mind and mood in modern art, II: depressive pressive illness. In: Programs and Abstracts. Twelfth Annual Meeting ofthe Child
disorders, spirituality, and early deaths in the abstract expressionist artists of the Neurology Society; 1983 Oct 13-15; Williamsburg, VA. Ann Neurol
New York school. Am J Psychiatry 1994;151:482-8. 1983;14:362.
46. Post F. Creativity and psychopathology: a study of291 world-famous men. Br J 66. Holden C. Manic depression and creativity. Science 1986;233:725.
Psychiatry 1994;165:22-34. 67. Kinney D, Richards R. Creativity and manic depressive illness. Science
47. Post F. Verbal creativity, depression and alcoholism. Br J Psychiatry 1986;234:528.
1996;168:545-55. 68. Hare E. Creativity and mental illness. BMJ 1987;295:1587-9.
48. Andreasen N, Canter A. The creative writer: psychiatric symptoms and family 69. Kessel N. Genius and mental disorder: a history of ideas concerning their
history. ComprPsychiatry 1974;15:123-31. conjunction. In: Murray P, editor. Genius: the history of an idea. New York: Basil
49. Andreasen N, Powers P. Creativity and psychosis: an examination of conceptual Blackwell; 1989. p 196--212.
style. Arch Gen Psychiatry 1975;32:70-3. 70. Richards R, Kinney D. Correspondence. Compr Psychiatry 1989;30:272-3.
50. Andreasen N. Creativity and mental illness: prevalence rates in writers and their
71. Miller A. The untouched key. London: Virago Press; 1990.
first-degree relatives. Am J Psychiatry 1987;144:1288-92.
72. Albert R. Genius and eminence. 2nd ed. New York: Pergamon Press; 1992.
51. Ludwig A. Mental illness and creative activity in female writers. Am J Psychiatry
1994;151:1650-6. 73. Goodwin D. Alcohol as muse. Am J Psychother 1992;46:422-33.
52. Rothenberg A. Psychopathology and creative cognition. Arch Gen Psychiatry 74. Jamison K, Wyatt R. Vincent van Gogh's illness. BMJ 1992;304:577.
1983;40:937--42. 75. Kinney D. The therapist as muse: greater roles for clinicians in fostering innova-
53. Karlsson J. Academic achievement of psychotic and alcoholic patients. Hereditas tion. Am J Psychother 1992;46:434-53.
1983;99:69-72. 76. Sacks O. Tourette's syndrome and creativity. BMJ 1992;305:1515-6.
54. Akiskal H, Akiskal K. Reassessing the prevalence of bipolar disorders: clinical 77. Simkin B. Mozart's scatological disorder. BMJ 1992;305:1563-7.
significance and artistic creativity. Psychiatry and Psychobiology 78. Whybrow P. Ofthe muse and moods mundane. Am J Psychiatry 1994;151:477-9.
I988;3(Suppl):29S-36S. 79. Sackett D, Haynes B, Tugwell P. Clinical epidemiology: a basic science for
55. Richards R, Kinney D, Lunde I, Benet M, Merzel A. Creativity in manic-depres- clinical medicine. Toronto: Little, Brown and Company; 1985.
sives, cyclothymes, their normal relatives, and control subjects. J Abnorm Psychol 80. Oxman A, Guyatt G. Guidelines for reading literature reviews. Canadian Medical
1988;97:281-8. Association Journal 1988;138:697-703.
56. Funk J, Chessare J, Weaver M, Exley A. Attention deficit hyperactivity disorder,
81. James W. The varieties of religious experience. New York: Collier Books; 1961.
creativity, and the effects of methylphenidate. Pediatrics 1993;91:816--9.
82. Lowry M. Under the volcano. Markham: Penguin Books Canada; 1985.
57. Roe A. Personal problems and science. In: Taylor C, Barron F, editors. Scientific
creativity: its recognition and development. New York: Wiley; 1963. p 132-8. 83. [Anonymous]. Eddie Vedder. People Magazine 1993 Dec 27:93.
58. Grant V. Great abnormals. New York: Hawthorn Books; 1968. 84. Jamison K, Gerner R, Hammen C, Padesky C. Clouds and silver linings: positive
59. Slater E. The problems of pathography. Acta Psychiatr Scand experiences associated with primary affective disorders. Am J Psychiatry
1970; (219 Suppl):2095-215S. 1980;137:198-202.
60. Andreasen N. James Joyce: a portrait of the artist as a schizoid. JAMA 85. Sontag S. Illness as metaphor and AIDS and its metaphors. Toronto: Doubleday;
1973;224:67-71. 1990.
61. Goodwin D. The muse and the martini. JAMA 1973;224:35-8. 86. Kuhn T. The structure of scientific revolutions. 2nd ed. Chicago: University of
62. Trethowan W. Music and mental disorder. In: Critchley M, Henson R, editors. Chicago Press; 1970.
Music and the brain. Illinois: Charles Thomas; 1977. p 398--432. 87. Eardley C. Artists are tougher than other people. The New York Times 1994May
63. Andreasen N. Creativity and psychiatric illness. Psychiatric Annals 1978;8:I 13-9. 6;Sect A:15.

Resume

Objectif: Evaluation critique des preuves scientijiques de I'association entre la creativite et la maladie mentale.
Methode: Des recherches menees dans MEDLINE et la litterature secondaire ont permis de reperer 29 etudes et
34 articles de synthese portant sur la creativite et la maladie mentale. Toutes les etudes ont fait l'objet d'une
evaluation critique, et on a aussi evalue les articles de synthese.
Resultats : Parmi les 29 etudes consacrees aI'evaluation des associationspossibles entre la creativite et la maladie
mentale, 15 etudes n 'ont permis de decouvrir aucune preuve du lien entre ces deux phenomenes, 9 etudes ont
donne des preuves concluantes et 5 se sont soldees par des resultats incertains. La plupart des etudes reposaient
sur des methodologies erronees et des plans (series de cas ou cas-temoins) superficiels. Aucune etude randomisee
ou prospective des cohortes n 'a ete menee. Les criteres appropries visant adeterminer I'association causale n 'ont
pas ete respectes. Dans 34 articles de synthese selectifs, malgre des preuves douteuses, de nombreux auteurs ont
pretendu qu 'il existe une association positive ou causale entre la creativite et la maladie mentale.
Conclusions: Des preuves scientijiques restreintes permettent d'associer la creativite a la maladie mentale.
Malgre cela, de nombreux auteurs ont soutenu I'existence d 'un lien entre ces deux phenomenes. Des explications
de cette contradiction font I 'objet d'un examen, et on discute des repercussions de celles-ci sur la societe et les
chercheurs.